Despite the relevance for occupational safety policies, the health effects of temperature on occupational injuries have been scarcely investigated. A nationwide epidemiological study was carried out ...to estimate the risk of injuries for workers exposed to extreme temperature and identify economic sectors and jobs most at risk.
The daily time series of work-related injuries in the industrial and services sector from the Italian national workers' compensation authority (INAIL) were collected for each of the 8090 Italian municipalities in the period 2006–2010. Daily air temperatures with a 1 × 1 km resolution derived from satellite land surface temperature data using mixed regression models were included. Distributed lag non-linear models (DLNM) were used to estimate the association between daily mean air temperature and injuries at municipal level. A meta-analysis was then carried out to retrieve national estimates. The relative risk (RR) and attributable cases of work-related injuries for an increase in mean temperature above the 75th percentile (heat) and for a decrease below the 25th percentile (cold) were estimated. Effect modification by gender, age, firm size, economic sector and job type were also assessed.
The study considered 2,277,432 occupational injuries occurred in Italy in the period 2006–2010. There were significant effects for both heat and cold temperatures. The overall relative risks (RR) of occupational injury for heat and cold were 1.17 (95% CI: 1.14–1.21) and 1.23 (95% CI: 1.17–1.30), respectively. The number of occupational injuries attributable to temperatures above and below the thresholds was estimated to be 5211 per year. A higher risk of injury on hot days was found among males and young (age 15–34) workers occupied in small-medium size firms, while the opposite was observed on cold days. Construction workers showed the highest risk of injuries on hot days while fishing, transport, electricity, gas and water distribution workers did it on cold days.
Prevention of the occupational exposure to extreme temperatures is a concern for occupational health and safety policies, and will become a critical issue in future years considering climate change. Epidemiological studies may help identify vulnerable jobs, activities and workers in order to define prevention plans and training to reduce occupational exposure to extreme temperature and the risk of work-related injuries.
•Health effects of extreme temperatures on occupational injuries have been scarcely investigated;•We found a significant effect of extreme temperature exposure on occupational injuries risk in Italy;•The identified pattern of susceptible workers could help regulators and governments for developing prevention measures;•Climate change scenarios suggest considering the prevention of extreme temperature occupational exposure as a priority.
Most recent studies have stressed a high risk of thromboembolism in patients with SARS-CoV-2 infection, particularly in those with severe COVID-19 pneumonia. Counterbalance between ...angiotensin-converting-enzyme (ACE) and ACE2 activities in COVID-19 disease may be crucially involved in the thrombo-inflammatory process. Currently, no study has investigated ACE I/D polymorphism involvement in COVID-19 disease complicated by pulmonary embolism, hence the aim of the present pilot study. This is a retrospective, single-center observational case-control study, conducted at the Sub-Intensive Care Unit of A.O.R.N. Ospedali dei Colli, Cotugno Hospital, Naples (Italy). We included 68 subjects with severe/critical COVID-19 pneumonia. COVID-19 patients were divided according to occurrence of PE (PE+,
= 25) or absence of thromboembolic complications (PE-,
= 43). Assessment of ACE I/D polymorphisms showed a statistically significant difference between PE+ and PE- patients (
= 0.029). Particularly, prevalence of D/D homozygous polymorphism was significantly higher in PE+ COVID-19 patients than in PE- (72 vs. 46.5%;
= 0.048), while heterozygote I/D polymorphism was significantly lower expressed in PE+ patients than in PE- (16 vs. 48.8%;
= 0.009). Computed tomographic pulmonary angiography showed predominantly mono/bilateral sub-segmental embolisms. In conclusion, our findings let us hypothesize a genetic susceptibility to thromboembolism in COVID-19 disease. ACE D/D polymorphism might represent a genetic risk factor, although studies on larger populations are needed.
Long-term exposure to air pollution has been related to mortality in several epidemiological studies. The investigations have assessed exposure using various methods achieving different accuracy in ...predicting air pollutants concentrations. The comparison of the health effects estimates are therefore challenging. This paper aims to compare the effect estimates of the long-term effects of air pollutants (particulate matter with aerodynamic diameter less than 10 μm, PM10, and nitrogen dioxide, NO2) on cause-specific mortality in the Rome Longitudinal Study, using exposure estimates obtained with different models and spatial resolutions. Annual averages of NO2 and PM10 were estimated for the year 2015 in a large portion of the Rome urban area (12 × 12 km2) applying three modelling techniques available at increasing spatial resolution: 1) a chemical transport model (CTM) at 1km resolution; 2) a land-use random forest (LURF) approach at 200m resolution; 3) a micro-scale Lagrangian particle dispersion model (PMSS) taking into account the effect of buildings structure at 4 m resolution with results post processed at different buffer sizes (12, 24, 52, 100 and 200 m). All the exposures were assigned at the residential addresses of 482,259 citizens of Rome 30+ years of age who were enrolled on 2001 and followed-up till 2015. The association between annual exposures and natural-cause, cardiovascular (CVD) and respiratory (RESP) mortality were estimated using Cox proportional hazards models adjusted for individual and area-level confounders. We found different distributions of both NO2 and PM10 concentrations, across models and spatial resolutions. Natural cause and CVD mortality outcomes were all positively associated with NO2 and PM10 regardless of the model and spatial resolution when using a relative scale of the exposure such as the interquartile range (IQR): adjusted Hazard Ratios (HR), and 95% confidence intervals (CI), of natural cause mortality, per IQR increments in the two pollutants, ranged between 1.012 (1.004, 1.021) and 1.018 (1.007, 1.028) for the different NO2 estimates, and between 1.010 (1.000, 1.020) and 1.020 (1.008, 1.031) for PM10, with a tendency of larger effect for lower resolution exposures. The latter was even stronger when a fixed value of 10 μg/m3 is used to calculate HRs. Long-term effects of air pollution on mortality in Rome were consistent across different models for exposure assessment, and different spatial resolutions.
•Chemical Transport, Random Forest and Lagrangian particle models used for exposure.•Building effects and city structure considered at different buffer sizes.•NO2 and PM10 long-term health effects evaluated by different models and resolution.•Significant associations with natural and cardiovascular mortality shown by all models.•Hazard Ratios for increments of interquartile ranges are not statistically different.
A source apportionment scheme based on gas and aerosol phase reactive tracers has been implemented in the chemical-transport model FARM, to efficiently estimate contributions of different sources to ...ambient concentrations. The on-line scheme deals with all the main processes that the chemical species undergo in the model, to enhance consistency with the calculation of bulk concentrations. The fate of precursors through gas-phase chemical reactions is followed by an efficient solver that determines their incremental reactivity, while the contributions to the secondary particulate species from their gaseous precursors is determined by assuming the thermodynamic equilibrium between the two phases. The paper details the new employed methodologies and illustrates the application of the apportionment scheme (based on 6 source sectors) to PM10 and O3, simulated on three domains of different dimensions in Italy, all sharing the same horizontal resolution and a common region (Lombardy). Spatial patterns of results show, on average, a relevant contribution of heating on PM10 concentration in January, with local hotspots dominated by road traffic. Contributions appear consistent in the three simulated domains, apart from the boundary conditions, influenced by the dimension of the domain. Hourly series of contributions to O3 concentrations in July at three selected sites show the dominance of boundary conditions, underlining the large scale of O3 formation. Finally, for PM10 components, the resulting sectorial contributions are compared with the impacts computed via the brute force method, showing that results are similar for elemental carbon and sulfate, while they are different for nitrate and ammonium, due to a different allocation of contributions and impacts between the methods. Each approach responds in principle to a different purpose, and their combined use provides possibly a wide set of information useful for addressing the different air quality management needs.
Diesel exhaust is hazardous to human health. In time, this has led the EU to impose on manufacturers lower and lower emission standards. These limits are very challenging in particular for nitrogen ...oxides (NOx) emitted by diesel-fueled vehicles. For the town of Milan (Italy), we used a complex modeling system that takes into account the NOx emissions from vehicular traffic and other urban sources, as well as their dispersion and chemical transformations in the atmosphere related to meteorological parameters. The traffic emissions in the Milan urban area were estimated using the geometric and structural characteristics of the road network, whereas the traffic flows were provided by the Environment and Territory Mobility Agency. Car emissions were estimated by the official European method COPERT 5. The nitrogen dioxide (NO2) concentrations were estimated under two scenarios: the actual scenario with real emissions and the Diesel Emission Standards Compliance (DESC) scenario. Using a recent meta-analysis, limited to European studies, we evaluated the relationship between NO2 concentrations and natural mortality. For the actual scenario, the NO2 annual concentration mean was 44.3 µg/m3, whereas under the DESC hypothetical scenario, this would have been of 37.7 µg/m3. This “extra” exposure of 6.6 µg/m3 of NO2 leads to a yearly excess of 574 “natural” deaths. Diesel emissions are very difficult to limit and are harmful for exposed people. This suggests that specific policies, including traffic limitations, need to be developed and enforced in urban environments.
Abstract
Background
Shipping and port-related air pollution has a significant health impact on a global scale. The present study aimed to assess the mortality burden attributable to long-term ...exposure to ambient particulate matter (PM
2.5
, PM
10
) and nitrogen dioxide (NO
2
) in the city of Ancona (Italy), with one of the leading national commercial harbours.
Methods
Exposure to air pollutants was derived by dispersion models. The relationship between the long-term exposure of air pollution exposure and cause-specific mortality was evaluated by Poisson regression models, after adjustment for gender, age and socioeconomic status. Results are expressed as percent change of risk (and relative 95% confidence intervals) per 5 unit increases in the exposures. The health impact on the annual number of premature cause-specific deaths was also assessed.
Results
PM
2.5
and NO
2
annual concentrations were higher in the area close to the harbour than in the rest of the city. Positive associations between each pollutant and most of the mortality outcomes were observed, with estimates of up to 7.6% (95%CI 0.1, 15.6%) for 10 µg/m
3
increase in NO
2
and cardiovascular mortality and 15.3% (95%CI-1.1, 37.2%) for 10 µg/m3 increase PM
2.5
and lung cancer. In the subpopulation living close to the harbour, there were excess risks of up to 13.5%, 24.1% and 37.9% for natural, cardiovascular and respiratory mortality. The number of annual premature deaths due to the excess of PM
2.5
and NO
2
exposure (having as a reference the 2021 World Health Organization Air Quality Guidelines) was 82 and 25, respectively.
Conclusions
Our study confirms the long-term health effects of PM and NO
2
on mortality and reveals a higher mortality burden in areas close to shipping and port-related emissions. Estimating the source-specific health burdens is key to achieve a deeper understanding of the role of different emission sources, as well as to support effective and targeted mitigation strategies.
Air quality modeling at the very local scale within an urban area is performed through a hybrid modeling system (HMS) that combines the CAMx Eulerian model the with AUSTAL2000 Lagrangian model. The ...enhancements obtained by means of the HMS in the reconstruction of the spatial distribution of fine particles (PM2.5) and elemental carbon (EC) concentration are presented for the case-study of Milan city center in Northern Italy. Modeling results are reported for three receptors (a green area, a residential and shopping area, and a congested crossroad on the inner ring road of the city center) selected in order to represent urban sites characterized by both different features in terms of the surrounding built environment and by different exposure to local emission sources. The peculiarity of the three receptors is further highlighted by source apportionment analysis, developed not only with respect to the kind of emission sources but also to the geographical location of the sources within the whole Northern Italy computational domain. Results show that the outcome of the Eulerian model at the local scale is only representative of a background level, similar to the Lagrangian model’s outcome for the green area receptor, but fails to reproduce concentration gradients and hot-spots, driven by local sources’ emissions.
Fabry disease (FD) (OMIM #301500) is a rare genetic lysosomal storage disorder (LSD). LSDs are characterized by inappropriate lipid accumulation in lysosomes due to specific enzyme deficiencies. In ...FD, the defective enzyme is α-galactosidase A (α-Gal A), which is due to a mutation in the
gene on the X chromosome. The enzyme deficiency leads to a continuous deposition of neutral glycosphingolipids (globotriaosylceramide) in the lysosomes of numerous tissues and organs, including endothelial cells, smooth muscle cells, corneal epithelial cells, renal glomeruli and tubules, cardiac muscle and ganglion cells of the nervous system. This condition leads to progressive organ failure and premature death. The increasing understanding of FD, and LSD in general, has led in recent years to the introduction of enzyme replacement therapy (ERT), which aims to slow, if not halt, the progression of the metabolic disorder. In this review, we provide an overview of the main features of FD, focusing on its molecular mechanism and the role of biomarkers.
This is the first study that quantifies explicitly the impact of present vegetation on concentrations and depositions, considering simultaneously its effects on meteorology, biogenic emissions, ...dispersion, and dry deposition in three European cities: Bologna, Milan, and Madrid. The behaviour of three pollutants (O3, NO2, and PM10) was investigated considering two different scenarios, with the actual vegetation (VEG) and without it (NOVEG) for two months, representative of summer and winter seasons: July and January. The evaluation is based on simulations performed with two state-of-the-art atmospheric modelling systems (AMS) that use similar but not identical descriptions of physical and chemical atmospheric processes: AMS-MINNI for the two Italian cities and WRF-CMAQ for the Spanish city. The choice of using two AMS and applying one of them in two cities has been made to ensure the robustness of the results needed for their further generalization. The analysis of the spatial distribution of the vegetation effects on air concentrations and depositions shows that they are highly variable from one grid cell to another in the city area, with positive/negative effects or high/low effects in adjacent cells being observed for the three pollutants investigated in all cities. According to the pollutant, on a monthly basis, the highest differences in concentrations (VEG-NOVEG) produced by vegetation were estimated in July for O3 (−7.40 μg/m3 in Madrid and +2.67 μg/m3 in Milan) and NO2 (−3.01 μg/m3 in Milan and +7.17 μg/m3 in Madrid) and in January for PM10 (−3.14 μg/m3 in Milan +2.01 μg/m3 in Madrid). Thus, in some parts of the cities, the presence of vegetation had produced an increase in pollutant concentrations despite its efficient removal action that ranges from ca. 17% for O3 in Bologna (January) to ca. 77% for NO2 in Madrid (July).
ObjectivesTo investigate the association between long-term exposure to airborne pollutants and the incidence of SARS-CoV-2 up to March 2021 in a prospective study of residents in Varese ...city.MethodsCitizens of Varese aged ≥18 years as of 31 December 2019 were linked by residential address to 2018 average annual exposure to outdoor concentrations of PM2.5, PM10, NO2, NO and ozone modelled using the Flexible Air quality Regional Model (FARM) chemical transport model. Citizens were further linked to regional datasets for COVID-19 case ascertainment (positive nasopharyngeal swab specimens) and to define age, sex, living in a residential care home, population density and comorbidities. We estimated rate ratios and additional numbers of cases per 1 µg/m3 increase in air pollutants from single- and bi-pollutant Poisson regression models.ResultsThe 62 848 residents generated 4408 cases. Yearly average PM2.5 exposure was 12.5 µg/m3. Age, living in a residential care home, history of stroke and medications for diabetes, hypertension and obstructive airway diseases were independently associated with COVID-19. In single-pollutant multivariate models, PM2.5 was associated with a 5.1% increase in the rate of COVID-19 (95% CI 2.7% to 7.5%), corresponding to 294 additional cases per 100 000 person-years. The association was confirmed in bi-pollutant models; excluding subjects in residential care homes; and further adjusting for area-based indicators of socioeconomic level and use of public transportation. Similar findings were observed for PM10, NO2 and NO. Ozone was associated with a 2% decrease in disease rate, the association being reversed in bi-pollutant models.ConclusionsLong-term exposure to low levels of air pollutants, especially PM2.5, increased the incidence of COVID-19. The causality warrants confirmation in future studies; meanwhile, government efforts to further reduce air pollution should continue.
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